Repeated mirror exposure in individuals with body dysmorphic symptoms [Author Accepted Manuscript]

Background and Objectives: Mirror exposure represents a common component in treatment of body dysmorphic disorder (BDD). However, the benefits of repeated mirror exposure have not been investigated as a standalone intervention for BDD. This study aimed to examine the cognitive and affective response to mirror exposure in individuals with high and low levels of body dysmorphic symptoms. Methods: Fifty women participated in two guided full-body mirror exposures (approx. 32 minutes each). Participants were divided into two groups based on the severity of their BDD symptoms. Twenty-three participants reported elevated, not primarily weight related, body dysmorphic symptoms. Body satisfaction and affective responses were assessed before and after the exposure, affective responses were further assessed during the exposure. Post-event processing related to the experience was rated the day afterwards. Results: Participants with body dysmorphic symptoms reported lower state body satisfaction and higher shame in both sessions, sadness was elevated in the first session only. State body satisfaction dropped from pre to post exposure but improved from the first to the second session. Negative affects did not decrease within but between the two sessions. Post-event processing after the first exposure predicted negative affect at the beginning of the second session. Discussion and Conclusion: The results support a positive effect of repeated mirror exposure across sessions, without improvement within the session. They point towards the detrimental role of mental post-processing.